Provider Demographics
NPI:1750076162
Name:KRAEMER, LUCAS PAUL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:PAUL
Last Name:KRAEMER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5053
Mailing Address - Country:US
Mailing Address - Phone:605-334-1672
Mailing Address - Fax:605-331-3243
Practice Address - Street 1:2333 W 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5053
Practice Address - Country:US
Practice Address - Phone:605-334-1672
Practice Address - Fax:605-331-3243
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24326183500000X
KS1-116133183500000X
NE17488183500000X
MN125567183500000X
MSE-100570183500000X
MI5302415172183500000X
SD6841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist